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Edna May THOMAS HONEYCUTT Birth Record Image |
| CERTIFICATE OF LIVE BIRTH
COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH, BUREAU OF VITAL STATISTICS Registration District No. 2641 |
|
| 1. PLACE OF BIRTH
a. COUNTY Norfolk b. CITY OR TOWN Portsmouth [X] Inside } Corporate [] Outside } Limits |
2. USUAL RESIDENCE OF MOTHER (Where does mother live?)
a. STATE Virginia b. COUNTY Norfolk |
| FULL NAME OF HOSPITAL OR INSTITUTION (If NOT in hospital or institution,
give street address or location)
523 Nelson St. |
c. CITY OR TOWN
Portsmouth [X] Inside } Corporate [] Outside } Limits
d. STREET ADDRESS (If rural, give mailing address) 523 Nelson St. |
| 3. CHILD'S NAME (If child is not yet named, leave
blank)
Edna May THOMAS |
|
| 4. SEX
Female 5.a. THIS BIRTH Single [X] Twin [] Triplet [] |
5b. IF TWIN OR TRIPLET (This child born)
1st [] 2nd [] 3rd [] 6. DATE OF BIRTH March 31, 1902 |
| FATHER OF CHILD | |
| 7. FULL NAME
George J. THOMAS |
8. COLOR OR RACE
White |
| 9. AGE (At time of this birth)
(Blank) YEARS 10. BIRTHPLACE (State of foreign country) Baltimore, Md. |
11a. USUAL OCCUPATION
Boiler Maker 11b. KIND OF BUSINESS OR INDUSTRY (Blank) |
| MOTHER OF CHILD | |
| 12. FULL MAIDEN NAME
Ida May RIXSE |
13. COLOR OR RACE
White |
| 14. AGE (At time of this birth)
(Blank) YEARS 15. BIRTHPLACE (State of foreign country) Baltimore, Md. 17. INFORMANT Mother |
16. CHILDREN PREVIOUSLY BORN TO THIS MOTHER (Do NOT include
this child)
a. How many OTHER children are now living? 0 b. How many OTHER children were born alive but are now dead? 0 c. How many children were stillborn (born dead after 20 weeks pregnancy)? 0 |
| I hereby certify that this child was born alive on the date stated above at _____ m. | 18a. SIGNATURE OF ATTENDANT
Chas. L. CULPEPPER, M.D. 18b. ATTENDANT AT BIRTH M.D. [X] MIDWIFE [] OTHER (Specify) 18c. ADDRESS Portsmouth, Va 18d. DATE SIGNED (Blank) |
| 19. DATE RECEIVED BY LOCAL REGISTRAR
March 1902 |
20. REGISTRAR'S SIGNATURE
F.S. HOPE, M.D. |
| 21. SUPPLEMENTAL INFORMATION:
(Blank) |
|
| FOR MEDICAL AND HEALTH USE ONLY (This section MUST be filled out) | |
| 22a. DURATION OF PREGNANCY
Term WEEKS 22b. WEIGHT AT BIRTH (Blank) LBS. (Blank) OZS. |
23. LEGITIMATE
YES [X] NO [] 24. WAS MOTHER'S BLOOD TEST PREFORMED? YES [] NO [] |
| 25. CONGENITAL MALFORMATIONS
YES [] NO [] |
26. WERE EYE DROPS USED?
YES [X] NO [] |
Many thanks goes to Phyllis Honeycutt Lalonde for sending in this record. To contact Cathy send email to [email protected] & to contact Phyllis send email to [email protected]
© Copyright 2000 , 2001 Cathy Cranford-Ailstock & Phyllis Honeycutt Lalonde. All Rights Reserved.
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